Short Term Missions Application

Terms and Conditions

Submitting this form does not guarantee that you will be selected to be a part of a ministry team. The church staff and the team leader have ultimate discretion as to who will join each team.

If you are selected to be a part of a team that has a cost associated with it, an initial, non-refundable, deposit will be required that will equal 25% of the cost of airfare for this trip, should airfare be required. Once tickets are purchased, should you change your mind, and without a valid excuse not be able to go on this trip, you will be responsible for the full balance of your ticket, and any financial penalties that resulted from the canceling of the ticket. If it is allowed by the airline, any voucher that would be available for the unused ticket for which you paid would belong to you.

While on this trip, you will represent your Savior and this church. You agree to not engage in any illegal, immoral, or suspect activity that would bring shame to either. You also agree to not utilize alcohol or tobacco products while on this trip.

By checking below, the participant (or parent/guardian if participant is a minor) acknowledges and accepts the risks of physical injury associated with participation in the activity associated with a missions trip. Except for gross negligence on the part of the sponser, the participant (or parent/guardian) accepts personal financial responsibility for any bodily injury sustained during the activity. Further, the participant (or parent/guardian) promises to hold harmless the sponsering orginization and its representatives for any injury related to the activity.

If a dispute over this agreement or any claim for damages arises, the participant (or guardian/parent) agrees to resolve the matter through a mutually acceptable arbitration process.

Do you Agree to these terms?
*

Yes No

A message from Bro. Lynn

Dear Mission Partner:

I am excited that you sense God's leadership to participate in one of our missions projects. Whether it is a Jerusalem, Judea, Samaria, or ends of the earth project, we take seriously our responsibility to share Christ with our world.

In the pages that follow you will find certain forms that must be processed in order for you to be considered for the project. Please read and follow all instructions carefully. If you have questions, your team leader will be glad to assist you.

I want you to know that I will be one of your personal prayer team members while you are serving on this mission trip. God has a great plan for you. Not only does He want to use you to minister to others, but He also wants to teach you and shape you into the image of Jesus through this experience. Ask Him for a submissive and teachable spirit so that He can accomplish all He desires to do in you and through you.

I look forward to your return and the reports of God's faithfulness in your life.

D. Lynn Hyatt

Personal Information

Full Name
*

First Name Middle Name Last Name

Birth Date
*

Month Day Year

Gender

Male Female

Marital Status

Address

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

Home Phone Number
*

-
Area Code Phone Number

Mobile Phone Number

-
Area Code Phone Number

E-mail

Preferred Contact Method
*

Home Phone Cell Phone Email Text Message Other option

If known, please list the trips for which you are interested in applying

Passport Information

Please fill out this information if you are planning on joining an international team. Please fill in your Driver's License name if you are applying for a domestic trip.

Passport Number

9 Digit Passport Number

Passport Expiration Date

-
Month
-
Day Year

City where Issued

City

State where Issued

State

Name as it appears on Passport (or Driver's License)

Passport (Driver's License) Name

Ministry Experience

How many years have you been a member of FBCC?

Years you have been a member

Discipleship Training Attended
*

First Moves (101) First Connections (201) First Discoveries (301) First Service (401) Not attended any

Ministries you have been involved in at FBCC

Ministries you have been involved in outside of FBCC

Training in Personal Evangelizm

Yes No

If yes, type of training?

Spiritual Gifts

Administration
*

1

2

3

4

5

Worst

Best

Evangelism
*

1

2

3

4

5

Worst

Best

Pastor/Teacher
*

1

2

3

4

5

Worst

Best

Wisdom
*

1

2

3

4

5

Worst

Best

Mercy/Helps
*

1

2

3

4

5

Worst

Best

References

Reference 1 Name
*

First Name Last Name

Relationship to Reference 1

Phone Number Reference 1

-
Area Code Phone Number

Email Reference 1

Reference 1 Address

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

Reference 2 Name

First Name Last Name

Relationship to Reference 2

Phone Number Reference 2

-
Area Code Phone Number

Email Reference 2

Reference 2 Address

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

Reference 3 Name

First Name Last Name

Relationship to Reference 3

Phone Number Reference 3

-
Area Code Phone Number

Email Reference 3

Reference 3 Address

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

Testimony

Salvation Testimony
*

What do you see as your role on a ministry team?

Emergency Information

Emergency Contact
*

First Name Last Name

Emergency Contact Address

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

Emergency Contact Email

Emergency Contact Phone

-
Area Code Phone Number

Emergency Contact Alternate Phone

-
Area Code Phone Number

General Health

Your Present Health
*

1

2

3

4

5

Poor

Execelent

Under the care of a Physician

Yes No

If yes, please describe

Please list any medications you are currently taking

Please list any allergies you have

Please explain any physical challenges that you may face on this ministry trip